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The Surgical outcomes of fundus-first technique in lowering the rate of bile duct injuries and bleeding during open cholecystectomy that facing intraoperative difficulties: A single-center prospective study: The surgical outcomes of open fundus-first cholecystectomy technique.
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Background: The problem of difficult gallbladder is not clearly defined and associated with real missing of therapeutic approaches that decreased morbidity. Moreover, the difficult gallbladder was reported as a contributing risk factor for biliary injury due to raised difficulty in surgical dissection within Calot’s triangle. The aim of this study is to determine the surgical outcomes of the open fundus-first cholecystectomy in lowering the rate of lethal intraoperative risks.

Subjects and Methods: Our prospective study conducted during the period of January 2019 to December 2022 at Ibn Sina specialized hospital, Khartoum, Sudan, for two hundred and fifty-three patients underwent elective open fundus-first cholecystectomy for intraoperative difficulties.

Results: the majority of cases had long-standing cholelithiasis with intraoperative difficulties revealed by pre-operative TUS and MRCP which required open fundus-first cholecystectomy in 173 (68.4%) of patients, (P-value <0.05). The operative surgical time was 120 minutes in 103 patients (40.7%), (P-value <0.05). During open cholecystectomy, variable intraoperative difficulties were found in all patients, (P-value <0.05) and were divided into: (A) Contracted intra-hepatic gallbladder seen in 157 (62.1%) of cases; (B) Distorted anatomy within Calot's triangle seen in 135 (53.4%) of patients; and (C) Intraoperative bleeding from the liver bed was observed as bloody oozing form in 150 (59.3%) of cases. Our patients had minimal postoperative complications like mild wound infection in 8 (3.2%) of cases and mortality rate was zero. 

Conclusions: There is a need for appropriate therapeutic and preventive strategies in healthcare systems for safe dealing with difficult cholecystectomy. Unclear anatomy due to severe inflammatory dense adhesions at Calot’s triangle and CBD stones needing difficult surgeries are the most important limiting factors for fundus-first laparoscopic cholecystectomy. Hence, we humbly recommend an open approach of fundus-first cholecystectomy as safe surgical option to reduce the incidence of bile duct injuries and intra-operative bleeding.

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Publication Date
Wed Jul 01 2020
Journal Name
Iop Conference Series: Materials Science And Engineering
Automation in architecture and its effect on the regeneration of traditional buildings: Al-Shawi House as a case study
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Abstract<p>The increased applications of technology in the field of architecture, especially digital technology and aspects of automation, have made a major impact on various aspects of local architecture, especially the traditional ones. As these technologies have succeeded in integrating many technological applications in many traditional and heritage buildings and taking them to more complex uses. And included in it characteristics that were not contained, therefore the research problem was concentrated in the absence of a holistic view of the role of the aspects of automation as a technological and design effect and its mutual effects on traditional buildings (especially the traditional Bagh</p> ... Show More
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Publication Date
Fri Jan 05 2018
Journal Name
Asian Quarterly: An International Journal Of Contemporary Issue
Refugees and the Challenges for Language Education (LE): A Theoretical Study
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DBN Rashid, Asian Quarterly: An International Journal of Contemporary Issue, 2018

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Publication Date
Tue Mar 15 2022
Journal Name
Al-academy
the indication of the scene as a symbolic system in the Iraqi theatrical
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The theatrical view reflects various connotations and intellectual and aesthetic implications, as the view includes a symbolic geometric, architectural and archetypal connotation suggestive of reality and nature, as theatrical art is the woman that reflects reality, specifically the significance of the theatrical view that reveals to us the philosophical, aesthetic and cognitive dimensions of theatrical trends, so the research came with the methodological framework, which It included the research problem (what is the significance of the scene as a symbolic system in the Iraqi theatrical performance), the importance of the research and the need for it, the research objective, the limits of the research and the most important terms.
A

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Publication Date
Wed Sep 30 2020
Journal Name
College Of Islamic Sciences
The Breadth in the meaning of the "from Surah Maryam as a model.
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Prepositions have a key function, which is to associate parts of a sentence, called letters In addition, it adds the meanings of the verbs to the names, ie reached by them, and called by the coffin characters Qualities..

          I chose to search for the meaning of the preposition "from" in Surat Maryam to know its meanings in terms of originality and expansion, so the title of the research (the meanings of preposition "from" in terms of originality and expansion in Surat Maryam model(

 

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Publication Date
Tue Jun 30 2015
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
Study the distribution of Fungi and Bacteria in AL- Yusifia River– South of Baghdad City.: Study the distribution of Fungi and Bacteria in AL- Yusifia River– South of Baghdad City.
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Al-Yusifia river was assessed at three sampling stations with study period from Autumn 2010 to the end of Summer 2011. The present investigation was carried out on diversity of fungi and bacteria from Al-Yusifia river, Baghdad city. During the study, a total of 12 fungal genus and 6 bacterial genus were isolated during the year seasons. The dominant fungus at the three stations were Penicillium sp., then Rhizopus and Trichophyton   megninii while the dominant bacteria was Escherichia coli and Klebsiella sp.

            The higher

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Publication Date
Thu Jan 30 2014
Journal Name
Al-kindy College Medical Journal
Rising Rate of Cesarean Section
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Cesarean section, which was introduced into clinical practice as a lifesaving procedure for both the mother and the baby, is one of the most common surgeries performed in modern obstetrics. Formerly it was performed in interest of the mother; currently it is frequently done for fetal indication. As other procedures of some complexity, its use follows the health care inequity pattern of the world; underuse in low income setting, and adequate or even unnecessary use in middle and high income setting (1).
The first modern cesarean section was performed by German gynecologist Ferdinand Adolf Kehrer in 1881. Cesarean section is often performed when a vaginal delivery would put the baby's or mother's life or health at risk. Many are also pe

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Publication Date
Mon Feb 04 2019
Journal Name
Journal Of The College Of Education For Women
The eloquence of the poetic image in the poetry of the Andalusian son of Labanism is a stylistic approach
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The resort to the eloquence of the poetic image as a style reveals the poet's creativity and creativity in dealing with external influences, and reflect them with emotional images express a sense of intense emotional imagination, and this imagination stems from the experience of a poetic sense of truth, tasted by the recipient before the creator of the poetic text.

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Publication Date
Wed Dec 14 2016
Journal Name
Journal Of Baghdad College Of Dentistry
Comparative Evaluation of the Effect of Different Universal Adhesives and Bonding Techniques on the Marginal Gap of Class I Composite Restoration (A SEM Study)
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Background: With the increase in composite material use in posterior teeth, the concerns about the polymerization shrinkage has increased with the concerns about the formation of marginal gaps in the oral cavity environment. New generation of adhesives called universal adhesive have been introduced to the market in order to reduce the technique sensitive bonding procedures to give the advantage of using the bonding system in any etching protocol without compromising the bonding strength. The aim of the study was to study marginal adaptation of two universal adhesives (Single bondâ„¢ Universal and Prime and Bond elect) using 3 etching techniques under thermal cycling aging. Materials and Methods: Forty-eight sound maxillary first premola

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Publication Date
Thu May 31 2012
Journal Name
Al-khwarizmi Engineering Journal
An Experimental Study on the Effect of Shape and Location of Vortex Generators Ahead of a Heat Exchanger
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An experimental study is carried out on the effect of vortex generators (Circular and square) on the flow and heat transfer at variable locations at (X = 0.5, 1.5, 2.5 cm) ahead of a heat exchanger with Reynolds number ranging from 62000< Re < 125000 and heat flux from 3000 ≤ q ≤ 8000 W/m2 .

In the experimental investigation, an apparatus is set up to measure the velocity and temperatures around the heat exchanger.                     

The results show that there is an effect for using vortex generators on heat transfer. Also, heat transfer depends on the shape and location. The circular is found t

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Publication Date
Wed Dec 28 2022
Journal Name
Al–bahith Al–a'alami
Public Relations Strategies in Building the State’s Reputation An analytical study of the publications of the website of the UAE Ministry of Foreign Affairs and International Cooperation
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The aim of this paper is to know the persuasive methods and public relations strategies in building the reputation of the United Arab Emirates, since the UAE is progressing among the international indicators in good reputation. The researcher used the survey method, using the content analysis tool, to analyze the publications of the UAE Ministry of Foreign Affairs and International Cooperation for the period from 10/1/2021 to 12/31/2021.The researcher reached a set of results, the most important of which are: The UAE Foreign Ministry relied on public relations strategies in order to build a good reputation for the country, as it focused on the media strategy and gave little importance to the consensus-building strategy, as well as focuse

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